Chronic Lymphocytic Leukaemia
Chronic lymphocytic leukaemia (CLL) is a blood cancer in which abnormal B lymphocytes accumulate in blood, marrow, lymph nodes and spleen.
Key takeaways
- Early asymptomatic CLL is commonly monitored without treatment because starting before a clinical indication has not helped everyone.
- Falling blood counts, enlarging nodes or spleen, rapid progression and constitutional symptoms can trigger treatment.
- Genetic markers and other illnesses influence targeted-therapy choice more than a single white-cell count.
The listings below are not a treatment plan; haematology should confirm diagnosis, indication and regimen.
Diagnosis and monitoring
A persistent clonal B-cell count with characteristic flow cytometry supports diagnosis. Blood count, examination and symptoms are tracked; bone-marrow biopsy and imaging are used selectively. Infection risk can be increased even before therapy because immune function is altered.
When treatment begins
Targeted medicines that inhibit B-cell signalling or BCL-2 have replaced much traditional chemotherapy in many settings. Selection depends on TP53 or related findings, kidney function, heart rhythm, bleeding risk and preference for continuous versus time-limited therapy. Vaccination and infection planning are part of care.
When to seek urgent care
Contact the treating team urgently for fever, uncontrolled bleeding, severe breathlessness, new confusion, rapidly enlarging painful nodes or marked weakness and fainting.